Individual
MAUREEN LORRAINE DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNSC
Contact information
Practice address
200 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3408
(859) 301-5901
(859) 301-5940
Mailing address
PO BOX 635283, ST. ELIZABETH PHYSICIANS, CINCINNATI, OH 45263-5283
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1097962
KY
363L00000X
Nurse Practitioner
Primary
3003706
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78007267
—
KY
Enumeration date
07/26/2005
Last updated
09/22/2015
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